- Associated Press - Monday, February 2, 2015

The Des Moines Register. Feb. 1, 2015.

Weak rules for care facilities worsen

If you’ve ever wondered what happens when an industry is allowed to regulate itself, wonder no more.

Two weeks ago, the state enacted a spate of new regulations that govern the 81 privately run residential care facilities that are home to more than 2,600 mentally and physically disabled Iowans.

Unfortunately, these and other new regulations represent a genuine threat to the health and safety of elderly and disabled Iowans. They actually increase residents’ risk of injury and death, and are almost guaranteed to result in lesser quality care.



One of the new rules eliminates a long-standing requirement that residential care facilities meet minimum staffing-level ratios. In place of these specific requirements, Iowa now has a vague and almost unenforceable requirement that the homes maintain an undefined “sufficient” number of workers.

That is the same meaningless standard that Iowa applies to nursing homes for the elderly. Since the old regulations specified a minimum level of staffing, the only change that could possibly result from the elimination of that standard is fewer caregivers. And yet inadequate staffing is widely cited as the single biggest contributor to neglect in care facilities. In fact, federal officials have estimated that more than 90 percent of all nursing homes are insufficiently staffed.

Just as troubling is the elimination of an explicit ban on the use of chemical restraints to control the behavior of residents. The new rules say only that the facilities must administer all of their drugs in accordance with a physician’s orders. This change flies in the face of recent reports that point to widespread overuse of tranquilizers and chemical restraints in care facilities nationwide.

Other newly enacted regulations for residential care facilities include:

Iowa no longer prohibits residential care facility managers from having “a record of habitual intoxication or addiction to drugs.” The new regulations say only that a manager cannot be “under the influence of intoxicating drugs or alcoholic beverages” while providing services in a care facility.

Iowa no longer requires that care facility managers be at the facility at least three full days of every working week. The state has also eliminated restrictions on the number of care facilities one administrator can manage, and it has done away with a rule that barred administrators from running two care facilities that were more than 50 miles apart. Under the new rules, one person can manage seven 20-bed facilities scattered across the state without ever setting foot in any of them.

Iowa used to require that the beds in residential care facilities be made daily, and that the homes “maintain” cleanliness. Those very basic requirements have now been wiped off the books, at the industry’s request, according to the Iowa Department of Inspections and Appeals. Now the homes are required only to “promote” cleanliness.

How are Iowans better served by these changes? What benefits will our disabled fellow Iowans derive from them?

A year ago, Iowa nursing homes weren’t allowed to operate for more than six months without a fully licensed administrator. Today, those same homes are allowed to operate that way for a full year. All they need is a “provisional administrator” who signs a statement claiming to be “knowledgeable” in the realm of senior care - but even that loose standard isn’t always enforced.

One Iowa nursing home is now being run by a man whose six-month provisional license expired last November. That’s not legal. If the state checked on facility management whenever an administrator’s license expired, they could prevent such violations. Instead, the state relies on the honor system.

To make matters worse, the Iowa Board of Nursing Home Administrators is considering a proposal that could actually reduce the educational requirements for people entering the profession.

Under the proposal, administrators would no longer have to meet requirements for specific areas of study, such as gerontology. Also, out-of-state individuals applying for an administrator’s license here in Iowa could do so with any sort of four-year degree, while the in-state applicants would need degrees in either business or health. And while the out-of-state applicants now need two years of on-the-job professional experience, that requirement would be eliminated under the proposed new rules.

This proposal comes at a time when, by all accounts, the medical needs of nursing home residents are becoming increasingly serious and complex as “healthier” Iowans migrate to in-home care or assisted living.

So how does all of this happen, you ask? Why are state regulators doing the bidding of the industries they oversee rather than protecting the public?

The answer: Money, access and influence.

Iowa doesn’t have any strong, grassroots advocacy organizations for the elderly and the disabled, but the industry does. It pays its lobbyists as much as $330,000 per year, according to tax records, and it funnels hundreds of thousands of dollars to statehouse candidates and gubernatorial hopefuls. Industry officials then wind up on the state boards that regulate their own companies.

David Chensvold, for example, is a past president of the Iowa nursing home industry’s main lobbying association, and has made more than $50,000 in contributions to political candidates here in Iowa and to the association’s political action committee. Chensvold now sits on the Iowa Board of Nursing Home Administrators, along with three other licensed administrators. It is these four individuals who have proposed the reduction in educational requirements for their own profession.

Their timing is fortuitous: Although the nine-member Board of Nursing Home Administrators is required to have two people representing the public’s interest, one of the two resigned in October and was never replaced. The other “public” member is a medical malpractice defense attorney.

This board has never been accused of being overly zealous in its work. In fact, last year the board took no public disciplinary action at all against any of Iowa’s 700 licensed administrators.

It’s no secret that Gov. Terry Branstad and many conservative legislators openly endorse this sort of “cooperative” approach to regulation. They have a get-tough stance on law enforcement as it relates to street crime, but when it comes to the laws that apply to business and industry, they are bleeding hearts, insisting on a “collaborative approach” to law enforcement and an end to what Branstad calls “the ‘gotcha’ mentality.”

In fact, the state is still playing “gotcha.” The difference is that today this declaration is no longer directed at the corporations that repeatedly failed to meet minimum standards of care, but at the thousands of elderly and disabled Iowans now living in state-licensed care facilities.

They are the ones who will have to live with new regulations that allow for absentee administrators, fewer caregivers, lower standards of cleanliness and the use of chemical restraints.

___

Sioux City Journal. Feb. 1, 2015.

Let’s pursue water quality in Iowa without lawsuits

Our hope is litigation can be avoided in the dispute between Des Moines Water Works and three rural Iowa counties over nitrates in water.

In our view, a lawsuit would be costly to Iowans, might be counterproductive to state efforts aimed at mitigation of agriculture nutrients, and would set a bad precedent for the future. Adjudicating a lawsuit might take years - years in which progress on reduction of nitrates can and, we believe, will occur.

We have to believe a better approach exists than fighting in court.

To this end, we urge the state Department of Agriculture to work aggressively, in whatever fashion it can, at preventing an escalation of this conflict.

On Jan. 8, the Des Moines Water Works board voted to file suit against drainage districts in Sac, Calhoun and Buena Vista counties over what it claims is nitrate pollution in the Raccoon River. The Raccoon River flows into the Des Moines River. The city of Des Moines can draw drinking water from both rivers.

We believe a state program called the Iowa Water Quality Initiative demonstrates the fact this state and its agriculture sector are engaged in the nitrate issue and committed to improvement.

Begun in 2013, developed by the Iowa Department of Agriculture, the Iowa Department of Natural Resources, and Iowa State University, and funded by the Legislature, the program seeks, in part, to significantly reduce levels of nitrogen produced by agriculture.

Agriculture Secretary Bill Northey last month requested the state budget include $7.5 million for the program in the next fiscal year; Gov. Terry Branstad included the request in his budget proposal. Part of the money is used to share with individual farmers the cost of implementing new water-quality practices.

Progress will take time, but the program shows early support and promise.

On July 24, 2014, for example, Northey announced all $1.4 million in state cost-share funds made available to help farmers install new nutrient-reduction practices in this fiscal year were obligated.

“The tremendous response to these cost-share funds shows again that farmers are committed to using voluntary, science-based conservation practices to continue to improve water quality,” Northey said at the time. “In less than one week, Iowa farmers committed to matching the state investment, so $2.8 million in new water quality practices will be going on the ground this fall.”

We do not criticize Des Moines Water Works for advocating on behalf of its water supply. In fact, by raising its concerns, DMWW raises the profile of and produces more discussion about this important issue.

Still, we believe the right course moving forward is to give the new state program time to produce results we believe Iowans outside and inside agriculture want to see. Through communication, cooperation, creativity and commitment, Iowans can, we are confident, find common ground in pursuit of a solution to this problem - outside of a courtroom.

___

Iowa City Press-Citizen. Jan. 31, 2015.

Iowa law not keeping pace with technology

Technology is advancing faster than the law, with one of the latest examples being body cameras worn by police officers.

With cutting-edge technology just a few years ago, the cameras have become standard equipment in police departments across the country, including here in Johnson County.

Body camera technology has the power to offer protection for the public and for officers by helping expose police wrongdoing and frivolous complaints against officers and by providing evidence for incident reports and court proceedings.

However, policies for body cameras are still being defined, including:

- Protocols regarding when to start and stop recording.

- Where data will be stored and how to safeguard against data tampering.

- How long recorded data will be kept.

- When video should be released to the public.

It’s the final point that concerns us most at the moment. As reported in today’s Press-Citizen, after initially declining a Press-Citizen open records request for body camera footage of UI police officers, UI later said it was reviewing its policy on releasing the video. The footage ultimately was released to the Press-Citizen on Friday.

Iowa law does not specifically address body camera video. However, the Iowa Public Information Board recently ruled that the city of Nevada’s police department did not have to release body camera footage. Police in the case asserted that the video was part of the “peace officers’ investigative reports” and was therefore a confidential record under Iowa Code.

That particular section of Iowa Code is vague - and the placement of a comma might have made it worse.

Iowa Code section 22.7 lists the “public records that shall be kept confidential unless otherwise ordered by a court, by the lawful custodian of the records, or by another person duly authorized to release such information.” The first sentence of Iowa Code section 22.7(5), reads: “Peace officers’ investigative reports, and specific portions of electronic mail and telephone billing records of law enforcement agencies if that information is part of an ongoing investigation, except where disclosure is authorized elsewhere in this Code.”

In its ruling, the Iowa Public Information Board cited a 2014 Polk County District Court ruling that said the phrase “if that information is part of an ongoing investigation” applied solely to “portions of electronic mail and telephone billing records” and not to “peace officers’ investigative reports,” making the investigative reports “confidential without condition.”

We’re not sure if the authors of Iowa Code section 22.7(5) meant for that comma to exclude investigative reports, but the court has decided that’s what the comma does.

The public information board has proposed legislation that would amend Iowa Code section 22.7(5) to replace the confidentiality provision with language from the federal Freedom of Information Act, which would keep law enforcement records confidential only if, among other things, they interfere with enforcement proceedings, constitute unwarranted invasion of privacy, disclose the identity of a confidential source or endanger the life or safety of an individual.

We urge the Iowa Legislature to take the IPIB’s proposal seriously. Last year’s court ruling could open a can of worms with the possibility of law enforcement broadening what it defines as an “investigative report” and what it withhold from the public.

We strongly advocate that videos be designated as public information subject to Iowa’s open record laws - with very specific restrictions for instances that would compromise an investigation or irreparably harm a person’s safety or privacy. We understand there has to be a balance, but that balance needs to favor open government.

We believe our local officials - as UI demonstrated Friday - can be leaders on this important issue of openness and transparency.

___

The Messenger. Jan. 31, 2015.

Federal debt poses a grave risk to U.S.

Many Americans are finally waking up to the damage being done by the $18 trillion national debt, both now and to future generations. Control of Congress by conservative Republicans provides some hope of curbing the deficit spending that continues to add to the debt.

Recently, the new GOP chairman of the Senate Budget Committee said he hopes to craft a plan to ensure balanced budgets within 10 years.

Trouble is, we’ve heard it all before. Both Democrats and Republicans in Congress and the White House pledge frequently to end deficit spending. They promptly find reasons it can’t be done.

The Budget Committee chairman, Sen. Mike Enzi, R-Wyoming, seems sincere. He said a balanced budget plan will be achieved “without gimmicks and bad accounting.”

Let’s hope so. But even if a blueprint to end deficit spending is prepared, it will signify nothing, really. Washington is a place where such plans are meant to be publicized, then forgotten. Unless voters hold future presidents and lawmakers to balanced budgets - resisting the temptation of new government programs - the debt burden will merely increase.

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